The relationship of bruxism with craniofacial pain and symptoms from the masticatory system in the adult population

Abstract

The association of bruxism with craniofacial pain and symptoms of dysfunction of the masticatory system was assessed in a sample of 483 adult subjects, aged 18±75 years and selected from the general population living in the municipality of Segrate, a metropolitan area in northern Italy. Subjects were interviewed by a questionnaire about oral conditions, occurrence of symptoms of masticatory disturbances, craniofacial and neck pain. The overall prevalence of bruxism was 31 á 4% (95% con®dence interval (CI): 27 á 3±35 á 5%). At univariate analysis bruxism was signi®cantly associated with craniofacial pain, dif®culty in closing the mouth, dif®culty in opening the mouth wide or in locking the mouth, temporomandibular joint sounds, pain on movement, a feeling of stiffness or fatigue of the jaws, and neck pain. After adjustment for reciprocal in¯uences and confounding variables, logistic regression analysis disclosed a strong independent association of bruxism with dif®culty in closing the mouth (adjusted odds ratio, (OR): 2 á 84, 95% CI: 1 á 68±4 á 48), and a weaker relationship with craniofacial pain (adjusted OR: 1 á 84, 95% CI: 1 á 16±2 á 93) and temporomandibular joint sounds (adjusted OR: 1 á 64, 95% CI: 1 á 00±2 á 69). The ®ndings show that in the general adult population there is a complex connection among bruxism, craniofacial pain and symptoms of masticatory disturbances. Furthermore, they suggest that the most direct relationship of bruxism may be with dif®culties in mouth movements, but also an independent association may exist with craniofacial pain and other symptoms of temporomandibular disorder.

Botulinum toxin type A combined with cervical spine manual therapy for masseteric hypertrophy in a patient with Alzheimer-type dementia: a case report

“…27,28 In fact, bruxism and temporomandibular disorders are usually associated with neck pain and muscle hyperactivity without specific anatomical modification. 29,30 To the best of the author's knowledge, the current study is the first case report in which manual therapy to the cervical spine combined with BoNT-A therapy showed promising results by improving masseter muscles spasticity and mouth opening in a patient with masseteric hypertrophy. …”

Effectiveness of botulinum toxin type A treatment of neck pain related to nocturnal bruxism: a case report

“…6 Published studies concerning BTX-A treatment of bruxism describe successful treatment of bruxism associated with TMD or traumatic brain injury. 23,28 Usually, bruxism and other TMDs are associated with neck and myofascial pain 20,21 with muscle hyperactivity without specific anatomical modification. Among the jaw elevator muscles, the masseter and temporalis muscles are those most often assessed in clinical evaluations and injected with BTX-A, with great clinical success.…”

“…However, the previous studies have not investigated the effect of botulinum toxin on neck pain caused by bruxism, only jaw pain due to bruxism or neck pain due to cervical dystonias. [18][19][20][21]28 Because neck pain is commonly coexisting with craniofacial pain in TMD, this case report may be of interest. The following is a case report of a patient presenting with nocturnal bruxism with related neck pain and treated with BTX-A.…”

“…This combination can do more benefit than the masseter-only injections. 20,21 Botulinum toxin type A was administered using specific guidelines as indicated in other reports. 11 The dose of BTX-A (Xeomin; Merzpharma, Frankfurt, Germany) injected into each masseter muscle was 40 mouse units (MU) with a dilution of 1 mL, whereas 25 MU with the same dilution was injected into the temporalis muscles bilaterally.…”

“…18,19 Usually, masseter and temporal muscle hyperactivity determines tension headaches and neck pain. 20,21 Therefore, it was hypothesized that the temporal and masseter muscles could be involved into the pathogenesis of bruxism; so BTX-A can be used to decrease the hyperactivity of these muscles for reducing this condition. [22][23][24] There are several reports in the literature, including a few randomized controlled studies (RCTs) and systematic reviews, 11,[25][26][27] of the favorable effect by botulinum toxin on craniofacial and neck pain as well as bruxism.…”